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Welcome to AtlantiCare “Discovery” New Vendor Orientation

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1 Welcome to AtlantiCare “Discovery” New Vendor Orientation
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3 Our Strategy Map (StratMap) 2014
Our Strategy Map helps us to align our goals and work with the mission, vision and goals of the organization. As we “provide health and healing to all people through trusting relationships” (our Mission), we see progress in our efforts to “build healthy communities” (our Vision). We categorize our work into 5Bs – Best People and Workplace, Best Customer Experience, Best Financial Performance, Best Growth and Best Quality. If you look at the StratMap under each of the 5 Bs, you will see the organization’s goal – for example, under Best Financial Performance is sustainability of our organization by maintaining an operating margin that allows us to continue to grow and reinvest in our organization and it’s employees. The StratMap also includes our organizational values to guide employees in daily interactions with each other and with our guests. Those values are Safety, Teamwork, Integrity, Respect and Services (STIRS). Our Customer Experience Standards are listed on the bottom of the StratMap. These standards are expected behaviors for all of us.

4 Corporate Organization
AtlantiCare AtlantiCare Regional Health Services AIT – AtlantiCare Information Technology AtlantiCare Heath Solutions AtlantiCare Foundation AtlantiCare Regional Medical Center AtlantiCare Health Services AtlantiCare Home Care AtlantiCare Health Engagement AtlantiCare Physician Group AtlantiCare Behavioral Health South Jersey Oncology Property LLC AMI/AtlantiCare Imaging AtlantiCare Surgery Center LLC AtlantiCare Cape May Surgery Center Health Care Delivery Health Information Health Solutions Rev 0214amg

5 Objectives At the end of this Discovery course, you will be able to:
Describe the culture here at AtlantiCare including our Mission, Vision and Values Demonstrate the appropriate behaviors to deliver Excellent Customer Experiences to our patients/customers Understand your personal contribution to our success as a vendor for AtlantiCare 5

6 A Day in the Life of AtlantiCare
This video, which takes a few moments to open, will give you a better understanding of the many services offered by AtlantiCare. Click here to view video 6

7 ·Customer Experience Index ·Operating Margin ·Re-admission Rate
KEEPING ATLANTICARE FIRST ·Employee Engagement ·Customer Experience Index ·Patients Cared for by Our Physician Network ·Operating Margin ·Re-admission Rate

8 Starfish Experience “Making the human connection at every moment during a patient’s journey” Here at AtlantiCare the starfish is used to describe how we make a difference in the lives of our patients and family members. That difference can be seen in the way we look at pleasing our customers. We call it the starfish experience. There are steps in place that build up to the starfish experience. In the next few slides we will introduce you to them as standards, best practice and finally the core components that make up the experience. All of our work in the customer experience B is aimed at making the human connection at every moment in a patients journey.

9 Excellent Customer Experience
An excellent customer experience is When an organization can constantly and consistently exceed customer’s expectations The extent that PEOPLE facilitate the PROCESSES to deliver a PRODUCT to the customer. In the Health Care industry today it is no longer about meeting the expectations of our customers, but in order to distinguish ourselves from others, from our competition, we have to exceed those expectations every time we provide service to our customers. The first step is understanding what those expectations are and recognizing those expectations will differ by business unit, service location and communities. The Senior Leadership team had the opportunity to go through this training program back in early April. I know you will enjoy it as much as we did and will walk away from this experience equipped with the concepts and skills to provide the high level of customer service our customers expect and support the overall organizational strategic objectives. Whether you are caring for a patient in the hospital, assisting a member working out on a piece of equipment at the Life Center, talking with a customer on the phone who has a question about their medical claim or calling someone in payroll with a question about your paycheck, we all have the same responsibility to treat whoever our customer is, internal or external with the same level of professionalism and respect. 9

10 Customer Service Standards
Determine how we deliver our service Guide the way we should act when we are providing service Support our mission, vision, values and the Five Bs of our Performance Excellence Commitments Should be incorporated into all we do 10

11 Customer Experience Standards
I will say “please” and “thank you” in all customer/co-worker interactions I will say “is there anything else I can help you with?” at the end of customer/co-worker interactions I will always identify myself, my department and say “may I help you” when answering the telephone I will always wear my name tag in a visible location I will smile, make eye contact and address others who are near me

12 Best Practice – Communication AIDET: 5 Fundamentals of Patient Communication
Acknowledge the customer, by name if you can. Greet them like a guest. I Introduce yourself and any team members who will be serving them. D Duration – how long does it take for this procedure, any wait time, etc. E Explanation – what will be done for the customer at this visit and why T Thank You – be appreciative they chose our services for their care In health care, patients are distracted, frightened, and often in pain. We may think we have communicated something clearly, but in reality our message was not received the way we intended. AIDET is a powerful formula for communication that allows us to: Share our experience, knowledge, & training Reduce anxiety & improve compliance Improve clinical outcomes Key Words at Key Times take the guesswork out of the health care equation so patients and families know we care for them as patients and as people. The following graph demonstrates the impact AIDET has on the patient experience.

13 Best Practice - Uniform Standards
Respiratory - Light Blue Lab – Wine Transport – Green Nursing – Navy PT – Olive Pharmacy – Black Imaging – Caribbean Blue Nursing Support – Gray Card. Diagnostics – Red EVS - Tan One best practice we have adopted here at AtlantiCare is the uniforms in patient care areas. Each department has a uniform color that was decided by a staff vote. These colors can help you identify each department, but also help our patients understand the role of each person taking care of them.

14 Best Practice – Hush Program (Environmental Noise)
Another example of a best practice is our Help Us Support Healing program or HUSH program. In an effort to reduce noise at night in the hospitals, the HUSH program is used to remind us each to take a personal responsibility to reduce our impact on environmental noise. You will see signs up at the entry to nursing units in the hospital as a reminder. Throughout all care delivery areas- Cell phone on vibrate Lower your voice Minimize environmental noise Address other environmental noise quickly

15 Best Practice – Call Light No Pass Zones
Call Lights Every patient call light is a request for help. If you are passing a call light in the hospital setting, please check with the patient to see if you can help. Please escalate the patient need to the appropriate team member as soon as possible. Another Best Practice is called the no pass zone. Regardless of your title, if you see a call bell in the hospital or if you have a request from any patient or family member, it is your responsibility to respond. Please ask the patient or family member if you can help them. Address the issue if you can. If you cannot please escalate the request to the person who can. (Dietary / EVS / Nursing / Security) For any call bell the nursing team will be responsible for turning off a call light. It is everyone’s responsibility to assist those entrusted to our care.

16 Managing Up Co-workers and Departments
When we transfer care, we want the transition to be seamless and comfortable. Speak positively to the patient about coworkers who will care for the patient after you, to reduce patient anxiety. This also gives your co-workers a head start in winning the confidence and trust of the patient. Example: “My team members in Radiology will take excellent care of you!” Speaking positively about coworkers, reduces patients’ anxiety about their next provider of care and puts them more at ease with the coordination of their care because it suggests strong teamwork among providers. “Hello Mrs. Woldow. I will be your physician today. I see that Mary is your nurse. We will be working together to make sure that we Always deliver excellent care. I have worked with her for almost 10 years. Mary and I will take excellent care of you during your stay with us at ARMC” Managing up also gives your co-workers a head start in winning the confidence and trust of the patient. If the patient trusts you, they will value your opinions regarding other providers. Here are some examples of managing up a coworker or department at the hospital. “Hello Mrs. Woldow. I have ordered a CT today. Our radiology department has state of the art technology and highly skilled staff . They are aware you are coming to their department and will take good care of you during your procedure.”

17 Customer Experience Service Recovery
Sometimes we don’t get it right the first time, and the customer is angry. It is our responsibility to do everything we can to correct the error. Our customer experience service recovery steps help us make amends with a disappointed or upset customer. The steps to service recovery are listed in the next column. Listen without interrupting the customer Recognize and respond to the problem Apologize for the problem Fix the problem – or transfer the problem to the team member who can fix it Thank the customer for bringing the error to our attention so we could fix it Any time we fail to meet our patients expectations we must initiate service recovery. Listen - Any employee receiving a service failure complaint must do an accurate intake of the patient complaint. Recognize - No matter how large or small the complaint, all employees must recognize the impact it has on our patient and take the appropriate actions to immediately resolve the issue. Apologize - Regardless of your department or title, we are all part of the AtlantiCare family and any service failure requires an apology by the complaint recipient. Correct the failure - Most patient and family frustration comes from the need to have multiple steps in correcting an issue. If you are performing service recovery it is your responsibility to ensure complete resolution Appreciate - Some of our greatest improvements have come from service failures. It is important to express that’s for the opportunity to resolve the service failure. By simply stating “Thank you for allowing me to assist you with this” conveys this.

18 Customer Interactions
Starfish Experience “Making the human connection at every moment during a patient’s journey” Narrating the Care Customer Interactions Sacred Moments Making the human connection at every moment during a patients journey requires that we stay alert. There components take a patient centered approach What we say – Narrating the Care How we think - Customer interaction What we do (at key moments) – Sacred Moments

19 Narrate the Care When we use the technique of narrate the care, we help patients, families and visitors “connect the dots.” This helps increase their health literacy by enhancing their understanding. Narrating the care also helps align our words with our actions to give a consistent experience and message. The patient better understands what you are doing to help them. When we use this technique while caring for patients, we create opportunities to maximize our potential for improving clinical outcomes while generating customer loyalty. Key Words at Key Times are the variables we plug into the AIDET formula to make our words both efficient and impactful. By taking advantage of everyday opportunities to communicate with intent, we maximize our potential for improving clinical outcomes while generating customer loyalty.

20 Examples of “Narrate the Care”
“I’m closing the curtain out of courtesy and respect for your privacy.” “We always want to get you the help you need, so when you press the call bell, one of the team members will respond.” Click on the next slide and ask your staff for specific examples that are appropriate to the work done in your department.

21 Customer Interaction Limit Distractions
limit distractions during customer interactions. Be sensitive to your impact on the their sense of well being. Empathy Address customer needs of with empathy. What if this was your loved one? Environment Is it private? Is it safe? Did we effectively communicate? Proactive Anticipate our customers needs and look to exceed expectations Patient and family interactions are the chapters in our patients story. The starfish experience is about being aware of your impact on a patient’s sense of wellbeing. It starts with Limiting distractions, looking at ourselves as part of the healing environment. The moving art. During patient and family interactions we take a step out of ourselves and take the approach from a patients perspective when addressing their physical needs. Our patients want to trust that their environment is safe, that they know what is happening at all times and that their privacy is maintained. We want our patients to focus more on recovery and less on their basic needs. So our goal is to to stay ahead of our patients care needs to maximize their ability to recover.

22 Sacred Moments This refers to moments of complete focus on the patient. At every first interaction with the customers (sitting down) Every time a customer asks a question (sitting when possible) When you are sharing important information When someone is leaving Sacred moments are moments of complete focus on the patient. It is called scared because we want to protect it. Sacred moments are moments that every customer regardless of location or setting must experience. Every customer meets us for the first time. The first encounter with our team is a sacred moment. This moment will impact the rest of the experience for every member of the team. When possible meet the customers at their level, both emotional and physical, sitting down if appropriate. When a customer asks you a question, they want to know that they have been heard, they are valued and that they have access to someone who has the answers. This requires all the attention we can offer. When a patient leaves it is the last moment for us to leave an impression, the last moment to exceed their expectations and the moment to write the last page in their story. Sharing information with our customers can be an extremely stressful time for them. We need to be sensitive to these moments and be mindful of how this information may impact them. This example and many others are sacred moments.

23 Measuring Customer Satisfaction - External Customers
Surveys: NRC Picker (National Research Corporation) HCAHPS (Hospital Consumer Assessment of Healthcare Providers Systems) CGCAHPS (Consumer and Group Assessment of Healthcare Providers and Systems) HHCAHPS (Home Health Consumer Assessment of Healthcare Providers and Systems) Internal Survey activity Web site and Social Media Focus groups / Community input We measure customer service through various ways: Surveys: NRC stands for National Research Consultants – outside company, phone survey, EDs & Inpatient units at ARMC; HCAHPS stands for Hospital Consumer Assessment of Healthcare Providers and Systems; CG-CAHPS stands for Consumer and Group Assessment of Healthcare Providers and Systems; HH-CAHPS stands for Home Health Consumer Assessment of Healthcare Providers and Systems. Internal Surveys – Customer Experience Dept at A’Care, covers all business units, standardize surveys, allows for internal benchmarking. With all surveys, look for best practices to share. We also hold patient focus groups and include members of the community in our patient and family advisory council to measure customer satisfaction. 23

24 ·Customer Experience Index
KEEPING ATLANTICARE FIRST ·Employee Engagement ·Customer Experience Index ·Patients Cared for by Our Physician Network ·Operating Margin ·Re-admission Rate

25 Healthcare Reform Old/Current: Fee for Service New/Current: Triple Aim
AtlantiCare is moving from a fee for service reimbursement to the healthcare reform formula, the triple aim. The reform includes customer experience scores, quality scores and cost efficiency. Quality Customer Experience Cost Efficiency

26 Best Financial Performance
Keeping AtlantiCare Strong Profit vs Non-profit Business Units Profits are reinvested in people, equipment and facilities Moody’s A1 credit rating One of the highest rated hospitals in NJ

27 ·Customer Experience Index
KEEPING ATLANTICARE FIRST ·Employee Engagement ·Customer Experience Index ·Patients Cared for by Our Physician Network ·Operating Margin ·Re-admission Rate

28 Best Quality AtlantiCare Wins Malcolm Baldrige National Quality Award

29 Quality Performance Measures and Organizational Commitments
How we benchmark and assess ourselves against outside measurements Malcolm Baldrige National Quality Award Magnet Status JCAHO We talked earlier about how we measure ourselves with our Jackson Customer Satisfaction surveys and our Trust Index Employee Survey. We also focus on looking at outside sources and comparisons to evaluate ourselves against key industry standards and measurements in healthcare. One such tool is the Malcom Baldrige National Quality Award for health Care. Malcolm Baldrige was Secretary of Commerce from 1981 until his death in He was a proponent of quality management as a key to our country’s long term prosperity and strength. Congress name this ward in his honor. The Baldrige Award is given by the president of the United States to businesses, manufacturing and service, small and large, and to education and healthcare organizations that are judged to be outstanding in seven areas: 1-leadership, 2-strategic planning, 3-customer and market focus, 4-measurement, analysis and knowledge management, 5-human resource focus, 6-process management and 7-results. For us it is not about winning the award, although that would be an achievement, it is more about a model and a process for our organization to achieve performance excellence. You will hear words and phrases like “fully deployed” “systematic” and “Every, Every, Every”. Throughout your experience here at AtlantiCare, you will have an opportunity to learn more about the Baldrige criteria and become involved in assisting our organization to achieve that level of excellence. The Magnet Status is an award given by the American Nurses’ Credentialing Center (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. A Magnet hospital is stated to be one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals are supposed to have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment. For the second consecutive year, AtlantiCare Regional Medical Center (ARMC) is honored by J.D. Power and Associates Distinguished Hospital Program(SM) for providing outstanding patient care. By surveying a random sample of patients, J.D. Power and Associates evaluated ARMC’s patient service in five key areas: dignity and respect; speed and efficiency; comfort; information and communication and emotional support. ARMC scored higher this year than in 2004 in all areas, and especially garnered high marks for tremendous improvement in providing patient comfort and delivering prompt and clear information and communication to patients. Notably, when compared to the national average, overall trust and confidence in the hospital is markedly higher among ARMC patients. 29

30 Cross-Cultural Services
Onsite Spanish Interpreter Services  Spanish Contracted Interpreter Services  All Languages Telephonic Interpreter Services All Languages Bilingual Staff Simple Conversation/ Emergency Situations Translation Service Vital Consent Forms/ Patient Education 30

31 Magnetic Resonance Imaging (MRI)
Click on link below picture to view MRI video mms://vmediaserver/MRI-Safety

32 Safety & Quality of Care – Reporting Concerns
You may contact the New Jersey Department of Health directly with complaints: Call Or by mail: NJ Department of Health PO Box 367 LL Trenton, NJ 08625 You may also contact the Joint Commission on Accreditation of Healthcare Organizations (JCAHO): Call From 8:30 am to 5 pm

33 Respiratory Etiquette to Prevent Seasonal Flu
Cover your mouth and nose with a tissue when you cough or sneeze If you do not have a tissue, cough or sneeze into your upper sleeve, not your hands Put used tissue in the trash Hey guys, I think I’m going to sneeze! Bad timing! Avoid touching eyes, nose and mouth Wash your hands frequently, especially after coughing or sneezing Get vaccinated annually for seasonal influenza

34 5 Moments For Hand Hygiene

35

36 ·Customer Experience Index
KEEPING ATLANTICARE FIRST ·Employee Engagement ·Customer Experience Index ·Patients Cared for by Our Physician Network ·Operating Margin ·Re-admission Rate

37 Growth and Innovation Show change video

38 Best Growth Recent additions to AtlantiCare include:
Galloway and Somers Point Urgent Care Sites Hammonton Health Park New AtlantiCare Pharmacy and Special Care Center in Galloway Multiple physician practices in tri-county area Plans for satellite campus in Manahawkin Plans for child & adolescent mental health center

39 Corporate Compliance Department
Independent support function of AtlantiCare reporting directly to the Board and administratively to Corporate Counsel. System-wide authority to act with respect to all entities, subsidiaries and cost centers. Responsibilities require unlimited and unrestricted access to all data during audits Conducts continuous assessments of the effectiveness of AtlantiCare’s compliance and internal control environment. 39

40 Laws to Protect Identity & Privacy
Red Flags Rule ID theft program designed to detect, prevent & mitigate ID theft. NJ ID Theft Prevention Act (NJITPA) Focus on specific security precautions to prevent ID theft, i.e. use of SS#. Requires breach notification. HIPAA (Health Insurance Portability and Accountability Act) Established standards for transmission and usage of health care information. HITECH (Health Information Technology for Clinical Health Act) Builds on HIPAA privacy & security of PHI, with modifications. Requires breach notification. Increases penalties & enhances enforcement provisions.

41 Protect Patient Information
Electronically Access for treatment, payment, and healthcare operations only Log off system when unattended Do not share usernames, passwords or ID badges No external devices or internet/software downloads into system Put the word “secure” in subject line of s containing PHI Report suspicious messages to InfoShare Customer Service Help Desk Paper Do not leave PHI unattended or remove from facility Lock paper files containing PHI in secure storage Fax to secure locations Properly dispose of confidential information in shred bins Verbally Speak quietly, limit discussion of PHI in public areas Use the minimum necessary rule – access, use & disclose for job performance only 41

42 Report Potential Compliance Violations
Report any activity that appears to violate AtlantiCare’s Code of Business Ethics, Corporate Compliance Code of Conduct or any applicable laws and regulations. If you are aware of a violation and fail to report it, you may be subject to corrective or disciplinary action. You may report anonymously. All complaints are documented and investigated. Maintained by third-party vendor: strict confidentiality protections are in place for all callers. No retaliation for reporting. Refer to AtlantiCare policy Guidelines for Reporting Compliance/Privacy Issues/Concerns Compliance Line Phone Number: (609) In-house Compliance Line Website: t.com (Access Code: ATC) 42

43 AtlantiCare’s Social Media Policy
Do not disclose any sensitive, proprietary, confidential or financial information about AtlantiCare on any social media. Do not comment on or disclose confidential AtlantiCare information. This includes protected health information, financial performance information regarding business operations, revenues, profits, information technology systems or application details, business plans, strategy or contracts. Do not publicly identify, cite or reference a client, partner or supplier by name or discuss their engagement with AtlantiCare without first obtaining their explicit, written permission. Non-work-related files should not be viewed or downloaded from social media sites using AtlantiCare electronic communication systems.

44 ·Customer Experience Index
KEEPING ATLANTICARE FIRST ·Employee Engagement ·Customer Experience Index ·Patients Cared for by Our Physician Network ·Operating Margin ·Re-admission Rate

45 Best People/ Best Workplace
Achievements Recognized by Modern Healthcare's Best Places to Work in Healthcare Launched Employee Resource Groups Benefits structured to encourage employee health & wellness Employee farm basket program

46 What is Harassment? Creation of a Hostile Environment:
The most frequent types are verbal, physical, and visual. Sexual Harassment A type of harassment based on a person’s gender or sexual orientation. Two forms of harassment: Quid Pro Quo harassment "This for That" harassment Hostile work environment Environmental harassment

47 Your Responsibility Report it! Your Supervisor Human Resources
Any other member of AtlantiCare Management An employee who believes he or she has been harassed, discriminated against, or subjected to any form of unprofessional and inappropriate behavior in is encouraged to immediately report the behavior to his or her supervisor, any member of AtlantiCare management if the employee does not feel comfortable reporting this to the supervisor, or to human resources. It is the responsibility of AtlantiCare management to report questionable conduct to the Director/Manager of Human Resources. To the extent possible, the complaint will be kept confidential depending upon the nature and scope of the complaint. Human Resources will investigate all allegations of unprofessional and inappropriate behavior and shall take proactive steps to address the conclusions of the investigation. No Retaliation!. No one who brings a complaint in good faith will be subject to any adverse employment action for doing so. Any employee, including management, who retaliates against an employee for making a complaint of harassment is subject to disciplinary action. 47

48 Equal Employment Opportunity
AtlantiCare values the dignity and worth of each individual. Each applicant and employee has equal opportunity -- the right to an environment free from discriminatory practices. AtlantiCare values the dignity and worth of each individual. Each applicant and employee has equal opportunity -- the right to an environment free from discriminatory practices. Each person is evaluated in every stage of employment based on merit only. Our policy and practice is that all employees be treated without regard to race, color, religion, gender, age, sexual preference, national origin, ancestry, marital status, physical or mental disability or disability assuming the employee can perform all of the essential job functions with or without reasonable accommodation, unfavorable discharge from military service or citizenship status. This policy of non-discrimination applies to all privileges or conditions of employment. 48

49 Safety is Our First Concern
You are required to immediately report to Human Resources any information that reasonably indicates another healthcare professional has demonstrated: Impairment Gross Incompetence Unprofessional Conduct AtlantiCare values the dignity and worth of each individual. Each applicant and employee has equal opportunity -- the right to an environment free from discriminatory practices. Each person is evaluated in every stage of employment based on merit only. Our policy and practice is that all employees be treated without regard to race, color, religion, gender, age, sexual preference, national origin, ancestry, marital status, physical or mental disability or disability assuming the employee can perform all of the essential job functions with or without reasonable accommodation, unfavorable discharge from military service or citizenship status. This policy of non-discrimination applies to all privileges or conditions of employment. 49

50 Impairment is defined as…
the condition of being unable to perform as a consequence of physical or mental unfitness. AtlantiCare values the dignity and worth of each individual. Each applicant and employee has equal opportunity -- the right to an environment free from discriminatory practices. Each person is evaluated in every stage of employment based on merit only. Our policy and practice is that all employees be treated without regard to race, color, religion, gender, age, sexual preference, national origin, ancestry, marital status, physical or mental disability or disability assuming the employee can perform all of the essential job functions with or without reasonable accommodation, unfavorable discharge from military service or citizenship status. This policy of non-discrimination applies to all privileges or conditions of employment. 50

51 Drug and/or Alcohol Abuse “Reasonable Suspicion”
If an employee appears to be under the influence of drugs/alcohol, (i.e. slurred speech, unable to walk in a straight line, etc.) Any other objective factors which raise a reasonable suspicion of alcohol or drug use Recurring or serious problems with job performance, attendance or behavior where no other verifiable basis for such a problem exists AtlantiCare values the dignity and worth of each individual. Each applicant and employee has equal opportunity -- the right to an environment free from discriminatory practices. Each person is evaluated in every stage of employment based on merit only. Our policy and practice is that all employees be treated without regard to race, color, religion, gender, age, sexual preference, national origin, ancestry, marital status, physical or mental disability or disability assuming the employee can perform all of the essential job functions with or without reasonable accommodation, unfavorable discharge from military service or citizenship status. This policy of non-discrimination applies to all privileges or conditions of employment. 51

52 Hostage or Active Shooter event

53 The Story of the Starfish
While walking on the beach one morning, a man saw a young boy running back and forth on the beach, throwing starfish into the ocean. He asked the boy, “Why are you throwing starfish into the ocean?” The boy replied, “The sun is up, the tide is going out, and these starfish will die on the beach.” The man replied, “There are thousands of starfish up and down the beach; you can’t possibly make a difference.” The boy picked up another starfish, ran to the breaking waves and threw it into the ocean. “I made a difference for that one,” he said. Make a Difference, One Person at a Time

54 You have completed the presentation and will need to take the test to complete the course.
Thank you, thank you, thank you!


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